Alzheimer, Alzheimer s Disease, COPD , Neurology , ICU
Conditions
Keywords
Hospital Malnutrition , Nutritional Risk Screening ,GLIM Criteria, Medication-Related Problems (MRPs
Brief summary
Malnutrition among hospitalized patients is a critical, yet often overlooked, public health issue associated with increased complications, longer hospital stays, higher mortality, and greater healthcare costs. In Iraq, factors such as dietary patterns, the burden of chronic diseases, and healthcare constraints may increase the risk of hospital-acquired malnutrition. Current standard care may not include systematic nutritional screening or protocol-driven support. This trial aims to test whether implementing an individualized nutritional support program can improve clinical outcomes for at-risk medical inpatients in Iraqi hospitals, building upon evidence from international studies
Interventions
OTHERNutritional Assessment and Medication Review
Intervention Description"This observational intervention consists of a multi-disciplinary clinical assessment conducted in three distinct phases for each enrolled participant:Validated Two-Step Nutritional Evaluation: Unlike standard hospital screening, this study uses the Nutritional Risk Screening (NRS-2002) as an initial filter. Patients identified as 'at risk' (score $\\ge$ 3) are immediately subjected to the Global Leadership Initiative on Malnutrition (GLIM) criteria. This provides a definitive diagnosis by combining phenotypic criteria (non-volitional weight loss, low BMI, or reduced muscle mass) with etiologic criteria (reduced food intake/malabsorption or disease-related inflammation/chronic illness).Specialized Comorbidity Analysis: The assessment specifically targets the impact of Chronic Obstructive Pulmonary Disease (COPD) and Alzheimer's Disease on nutritional status, evaluating how respiratory hypermetabolism and cognitive impairment act as independent drivers of malnutri
Sponsors
AlFayhaa General Hospital
University of Basrah
Ministry of Health, Iraq
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age: Adult patients aged $\\ge$ 18 years.Setting: Patients admitted to the Medicine, Surgery, or Neurology Intensive Care Unit (ICU) wards at Al-Basrah Teaching Hospital or Al-Fayhaa General Hospital.Duration of Stay: Patients who have been hospitalized for a minimum of 48 hours (to ensure a baseline for malnutrition screening and medication review).Clinical Conditions: Patients with various primary diagnoses, including specific subgroups with Chronic Obstructive Pulmonary Disease (COPD) and Alzheimer's Disease.Informed Consent: Patients or their legal guardians (especially for those in the ICU or with cognitive impairment) who provide written or verbal informed consent.
Exclusion criteria
* Maternity/Obstetrics: Pregnant or lactating women, as nutritional requirements and physiological BMI changes differ from the general adult population. Terminal Illness: Patients in end-of-life or palliative care where nutritional intervention is no longer a clinical goal. Incomplete Records: Patients with missing medical or medication charts that prevent the accurate identification of Medication-Related Problems (MRPs). Short Stay: Patients planned for discharge or transfer within less than 48 hours of admission. Psychiatric Disorders: Patients with primary psychiatric diagnoses that may interfere with the ability to conduct nutritional assessments (unless a guardian is present).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| oint Prevalence of Malnutrition using GLIM Criteria and NRS-2002 | Within 48 hours of hospital admission | The primary goal is to determine the prevalence of malnutrition among hospitalized adult patients in Al-Basrah Teaching Hospital and Al-Fayhaa General Hospital. All participants are first screened using the Nutritional Risk Screening (NRS-2002). For those identified as "at risk" (score $\\ge$ 3), a definitive diagnosis is made using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Diagnosis requires at least one phenotypic criterion (non-volitional weight loss, low BMI, or reduced muscle mass) and one etiologic criterion (reduced food intake/malabsorption or disease-related inflammation/chronic illness, such as COPD or critical illness in the Neurology ICU). The prevalence will be reported as the percentage of the total cohort meeting the GLIM diagnostic threshold. |
| Point Prevalence of Malnutrition using GLIM Criteria , NRS2002 | Within 48 hours of hospital admission. | The primary goal is to determine the prevalence of malnutrition among hospitalized adult patients in Al-Basrah Teaching Hospital and Al-Fayhaa General Hospital. All participants are first screened using the Nutritional Risk Screening (NRS-2002). For those identified as "at risk" (score $\\ge$ 3), a definitive diagnosis is made using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Diagnosis requires at least one phenotypic criterion (non-volitional weight loss, low BMI, or reduced muscle mass) and one etiologic criterion (reduced food intake/malabsorption or disease-related inflammation/chronic illness, such as COPD or critical illness in the Neurology ICU). The prevalence will be reported as the percentage of the total cohort meeting the GLIM diagnostic threshold. |
Contacts
CONTACTmawj ali Principal Investigator, College of Pharmacy, University of Bas, BPharm
Outcome results
None listed